Senate Democrats Say Cost of Health-Care Bill Can Be Trimmed

ROBERT PEAR

Friday

Jun 26, 2009 at 5:10 AM

Democrats said they had found ways to pare the cost of the bill by more than a third while still covering nearly all Americans.

WASHINGTON — Senate Democrats said Thursday that they had found ways to pare the cost of a health care bill by more than a third — to $1 trillion over 10 years — while still covering nearly all Americans.

One of the Democrats, Senator Max Baucus of Montana, the chairman of the Finance Committee, said the new policy options provided a feasible route toward enactment of the legislation, which is President Obama’s top domestic priority.

But as senators leave town for a weeklong Fourth of July break, Democrats are nowhere near where they had hoped to be.

The Democrats had hoped that two Senate committees would approve the legislation by the end of this week. The measure could affect nearly every family, employer and health care provider in the country.

Still, Mr. Baucus was upbeat. After a meeting of his committee on Thursday, he said, “The Congressional Budget Office now tells us we have options that would enable us to write a $1 trillion bill, fully paid for.”

While senators haggled over the intricacies of policy, thousands of people held a rally in a park nearby demanding “health care reform now.” The crowd included doctors, nurses, labor union leaders and people without insurance. Many urged Congress to create a public health insurance plan, as a possible alternative to private insurance.

Mr. Baucus’s bill is likely to include a new tax on some employer-provided health benefits and a requirement for employers to help pay the cost of insurance for some of their low-income workers — those who enroll in Medicaid or get federal subsidies to help them buy insurance.

Medicare cutbacks would provide a third major source of money to help finance coverage of the uninsured. Senators expect to trim Medicare payments to hospitals and many other health care providers.

Senator Kent Conrad, Democrat of North Dakota, said the overall cost of the bill had been reduced mainly by limiting eligibility for various subsidies. Assistance would originally have been available to people with incomes up to 400 percent of the poverty level ($88,200 for a family of four). Democrats have lowered the ceiling to 300 percent of the poverty level ($66,150 for a family of four).

Senators said the cost of the bill might also be reduced by dropping or scaling back a plan to give tax credits to small businesses, to help them buy insurance. Mr. Baucus, like House Democrats, wants to expand Medicaid to cover millions more people. But to save money, he and other Senate Democrats may delay the start of the expansion for three years, to 2013.

A bipartisan group of seven senators, including Mr. Baucus and Charles E. Grassley of Iowa, the senior Republican on the Finance Committee, had been hoping to announce a deal on Thursday. With no agreement, they issued a statement in which they promised to keep working.

“Over the past several months, we’ve made progress toward workable solutions,” the group said. “We are committed to continuing our work toward a bipartisan bill that will lower costs and ensure quality, affordable care for every American.”

The statement was a status report, but also a political document, meant to buck up the spirits of advocates of major health care legislation, who insist that public opinion is on their side, despite setbacks on Capitol Hill.

Mr. Conrad said the Finance Committee had made “remarkable progress” in whittling down the bill’s initial price tag of $1.6 trillion.

“Think of where we started this week,” Mr. Conrad said. “We were $600 billion away from having a package that added up. Now we have a number of options that all add up. We know we can have a bill that’s completely paid for, at $1 trillion.”

Senator Olympia J. Snowe, Republican of Maine, one of the core group of seven striving for an agreement, emphasized that “we have not made a deal.” But she added, “there will be no hiatus during the recess,” as senators and their aides push ahead.

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